chlamydia
December 22, 2010 | 10,00 EUR | answered by Dr. med. Ralf Berg
Dear Sir or Madam,
I have a question. About 3 weeks ago, I started experiencing the first symptoms: a slight burning and itching in the penis and a light whitish discharge (more so overnight). I have not seen a doctor to clarify the question beforehand. I took a single dose of CIPROFLOXACIN 500mg to rule out Gonorrhea. Unfortunately, it did not improve and my left testicle started to slightly ache, but it is neither red nor swollen, so my suspicion turned to a Chlamydia infection. I then took AZITHROMYCIN 1g (single dose, started treatment 3 days ago, I know that it can take about 4 days to see improvements). The discharge has decreased but not gone away, and the burning and occasional itching only occur when urinating and mainly in the morning. I have been drinking 2-3 liters of water in the past few weeks. My question now is whether the inflammation of the testicle caused by the single dose of AZITHROMYCIN 1g I took 3 days ago (assuming the infection was caused by Chlamydia) will go away, or if this inflammation in the testicle needs to be treated with a different antibiotic. Additionally, I would like to know how long it takes for the symptoms to completely subside after taking AZITHROMYCIN 1g (if it is a Chlamydia infection).
Thank you in advance for your response.
Well,
to anticipate it, now getting a proper diagnosis regarding the pathogens will be difficult, because for that you would have had to take a urine sample BEFORE taking various antibiotics. Also, one cannot "rule out" gonorrhea by taking antibiotics, but only by determining the bacteria in the discharge. If I interpret it correctly, your diagnosis of chlamydia infection so far is based solely on a presumption, or was there evidence of chlamydia infections in your sexual partners? Chlamydia infection in men often progresses rather mild, with few symptoms, so I would include a broader spectrum of pathogens in the therapy. My advice and answer to your question is that you should get examined by the 4th day at the latest if there is no improvement. Starting another antibiotic therapy online is not advisable. I would be lying to myself if I were to simply suggest more antibiotics to you here without having examined you. Remember: before therapy, the diagnosis (and of course the examination to arrive at a suspected diagnosis) is essential. According to your description, not only inflammations of the urethra, bladder, and prostate need to be considered, but also, since you also have pain in the testicular area, testicular inflammations, but also what is much more common, epididymitis. A manual examination is necessary for this. Especially epididymitis must be treated long-term (unlike chlamydia). Because severe or long-lasting epididymitis can also lead to reduced fertility, I urge you to visit a colleague (general practitioner or urologist) for an examination.
With best regards and best wishes for the Christmas season,
Dr. R. C. Berg
